HomeMy WebLinkAboutMortgage_Lutz (7)�* STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
� FOR DEDUCTION FROM ASSESSED VALUATION Coun Township Year
'�+ «� / State Form 43709 (RS I 4-03) '
' PresaiDetl by Department of Local Govemment Finance '
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INSTRUCTIONS: � � � File M�/
To be filed in person or by mail with the Counry Auditor o( the county where the property is located. A�(; Q 8 2Q03
Filing Dates: 1) Real Property: During the 12 months before May 11 0l the year the deduction is to 6e etFechve.
2) Mobile Homes assessed under IC 6-1.1-7: Between January 15 and March 2 o%the year the deduction is to be eHective.
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See reverse side !or additronal instnictions and qualifrcations. /� _ " J�� ��
i � G13SON COU's'�• °��n��C^
Appiicant (owner or contracf 6 - see restri io on r erse side)
Taxing District Key number / le description Record number
D/ � /�!��� )'��y � Page number
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Assesse va ue of real property as of MoAgage / Contract indebtedness unpaid as of Is the applicant the sole legal or equitable
March 1, current year March t,�nt year owneR ❑ Yes ❑ No
If no, what is his / her exact share of interest? � If owned with someone other lhan spouse, indicate with whom.
If name on record is different lhan lhat of appiicant, indicate below: Is the property in question:
❑ Real Property O Moble Home (IC E1.1-�
��me of mortgagee or contract seller � ^
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Address of moAgagee or contrad seller (number and st2et, city, state, ZIP
Name of assignee or other owner or holder of mortgage
Address of assignee (numberand stieef, city, state, ZIP code)
Does applicant own property in any other if yes, what counry? What Taxing Distrid? Has this dedudion been requested on
county in Indiana? property for wrrent yeai'?� Yes❑ No
COUNTY AUDITOR
Dedudion approved in the amount of:
20 �� 20 �_ 20 20 0 20 ('�� 20 � 20
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Signature County Auditor Date
�/ We rfify under the penalty of perjury that the above and foregoing information is true and corred and that lhe applicants was / were
resi ndiana and owner of the aforementioned property on March 1. 20
'g ur (own rs full nam Person authorized by duly executed Power of Attorney
or by IC 6-1.1-12-.07
F II r i t ss a icant Address of authorized person
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